CHAD LEWIS KASSUBE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138088

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

LEWIS

Last Name

KASSUBE

Business Name

CHAD LEWIS KASSUBE

Original Issue Date

09/11/2001

Effective Date

09/11/2001

Expiration Date

03/31/2003

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005